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Venous thromboembolism in women using hormonal contraceptives - Findings from the RIETE Registry

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245
DOI: https://doi.org/10.1160/TH08-10-0684
Issue: 2009: 101/3 (Mar) pp. 413-603
Pages: 478-482

Venous thromboembolism in women using hormonal contraceptives - Findings from the RIETE Registry

Ángeles Blanco-Molina 1; Javier Trujillo-Santos 2; Raimundo Tirado 3; Inmaculada Cañas 4; Antoni Riera 5; Mariano Valdés 6; Manuel Monreal 7; for the RIETE Investigators
1 Department of Internal Medicine, Hospital Universitario Reina Sofía, Córdoba, Spain; 2 Department of Internal Medicine, Hospital Universitario Santa María de Rosell, Cartagena, Murcia, Spain; 3 Department of Internal Medicine, Hospital Infanta Margarita, Cabra, Córdoba, Spain; 4 Department of Internal Medicine, Hospital General de Granollers, Granollers, Barcelona, Spain; 5 Department of Internal Medicine, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain; 6 Department of Internal Medicine, Hospital de Viladecans, Viladecans, Barcelona, Spain; 7 Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain

Keywords

prevention, venous thromboembolism, Contraceptives

Summary

There is scarce information on the clinical characteristics of contraceptive users who develop venous thromboembolism (VTE). RIETE is an ongoing registry of consecutive patients with symptomatic, objectively confirmed, acute VTE. We analyzed the clinical characteristics and additional risk factors for VTE in all enrolled women aged <50 years who were using or not using contraceptives at presentation with VTE. Of 1,667 women aged <50 years enrolled in RIETE as of December 2007, 593 (36%) were contraceptive users. Of 270 aged <25 years, 190 (70%) were users. Ninety-two contraceptive users (16%) had overweight, 89 (15%) were obese. Of 951 women with no additional risk factors for VTE (i.e. recent surgery, immobility or cancer) 457 (48%) were contraceptive users. Eighty-seven (15%) users had recent immobility for ≥4 days, 44 (7.4%) were postoperative. The most common reason for immobility was lower limb trauma not requiring surgery; 25% of users with recent immobility had received thromboprophylaxis. The most common type of surgery was non-major orthopaedic surgery. Twenty-one (48%) users with postoperative VTE had received prophylaxis. The percentage of users and non-users who tested positive for thrombophilia was similar. Contraceptive use remains the most frequent risk factor for VTE in women at fertile age. Identifying those at increased risk for VTE seems to be difficult. In the meanwhile, a higher use of thromboprophylaxis during immobility or minor surgery should be warranted.

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